Predictive factors for severe epistaxis in a tertiary center of Tunisia

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Published Dec 1, 2024
https://doi.org/10.62438/tunismed.v102i12.5210
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Vol. 102 No. 12 (2024): Tunis Med dec 2024

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Malika El Omri
Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of Sousse, Tunisia
Hadil Ben Kahla
Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of Sousse, Tunisia
Souhir Chelly
Occupational Health Department, University Hospital Centre Farhat Hached, Faculty of Medicine of Sousse, University of Sousse, Tunisia
Mouna Bellakhdher
Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of Sousse, Tunisia
Wassim Kermani
Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of Sousse, Tunisia
Mohamed Abdelkefi
Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of Sousse, Tunisia

Abstract

Introduction: Epistaxis is a prevalent clinical condition that can be associated with significant morbidity and places a considerable burden on the healthcare system.


Aim: To ascertain the prevalence of epistaxis in our center and to identify the predictive factors of severity.


Methods: This is a retrospective cross-sectional analytical study of patients who presented to and/or were admitted for epistaxis at our department of Ear, Nose and Throat (ENT) during the period from January 2015 to December 2022.


Results: A total of 720 patients were included out of a total of 100,378 consultations, resulting in a prevalence of 0.7%. The mean age of the patients was 51.6 years (±18,73 Standard Deviation (SD)) and the sex ratio H/F was 1.43. The majority (87.9%) of cases were benign and treated on an outpatient basis, while 12.1% of patients presented with severe epistaxis and required hospitalization. The median duration of hospitalization was 5 days. The outcome was favourable in 99.4% of cases. Nevertheless, two cases of death due to severe epistaxis complicated by hemorrhagic shock were observed. A multivariate analysis identified several independent factors associated with severe epistaxis. These included male gender, recurrent epistaxis, a history of hematological disorders, the use of anticoagulant therapy, and an increased International Normalized Ratio (INR) level.


Conclusion: These results have made a significant contribution to our understanding of the severity factors associated with epistaxis, enabling a more targeted and personalized approach to prevention and treatment.

Keywords:

Epistaxis , Bleeding , Severity criteria, Risk Factors , Self-Management

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